Orthorexia Nervosa: When Righteous Eating Becomes An Obsession

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Orthorexia nervosa, the “health food eating disorder”, gets its name from the Greek word ortho, meaning straight, proper or correct. This exaggerated focus on food can be seen today in some people who follow lifestyle movements such as “raw”, “clean” and “paleo”.

American doctor Steven Bratman coined the term “orthorexia nervosa” in 1997 some time after his experience in a commune in upstate New York. It was there he developed an unhealthy obsession with eating “proper” food, "all I could think about was food. But even when I became aware that my scrabbling in the dirt after raw vegetables and wild plants had become an obsession, I found it terribly difficult to free myself. I had been seduced by righteous eating."

Bratman’s description draws parallels with many modern dietary fads that promise superior health by restricting whole food groups without a medical reason or even a valid scientific explanation.

Raw food followers might meet regularly to “align their bodies, minds and souls” by feasting on “cleansing and immune-boosting” raw foods. Such foods are never heated above 44˚C, so “all the living enzymes in the food remain intact”. No gluten, dairy or “sugar” is allowed.

Clean eaters may follow similar regimes, removing gluten, dairy and even meat from their diets. You might overhear a discussion about “superfood green smoothie” recipes after a yoga class that also happened to “cleanse your gall bladder”.

And finally, around the corner, paleo pushers may “beef up” together with a Crossfit class, followed by a few steaks. Again, with paleo, there is no gluten – or any grains for that matter – and no dairy or other such “toxins” are allowed.

Orthorexia nervosa is not listed in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5), which psychologists and psychiatrists use to diagnose mental disorders. The DSM-5 currently lists anorexia nervosa, bulimia nervosa, binge-eating disorder, “other specified feeding or eating disorder” and “unspecified feeding or eating disorder”.

Some clinicians argue orthorexia nervosa should be recognised as a separate eating disorder and have proposed clinical DSM diagnostic criteria. They note distinct pathological behaviours with orthorexia nervosa, including a motivation for feelings of perfection or purity rather than weight loss, as they see with anorexia and bulimia.